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Health & Wellbeing Board
Wednesday, 10th February, 2016

Health & Well-Being Board (Croydon) Minutes

Date:
Wednesday 10th February 2016
Time:
2:00pm
Place:
The Council Chamber, The Town Hall, Katharine Street, Croydon CR0 1NX
 

Attendance Details

Present:

Elected members of the council:

Councillors Alisa FLEMMING, Yvette HOPLEY, Maggie MANSELL (Chair), Margaret MEAD (Vice-Chair), Louisa WOODLEY

 

Officers of the council:

Paul GREENHALGH (Executive Director of People)

 

NHS commissioners:

Dr Agnelo FERNANDES (NHS Croydon Clinical Commissioning Group)

Paula SWANN (NHS Croydon Clinical Commissioning Group)

 

Healthwatch Croydon

Charlotte LADYMAN (Healthwatch Croydon)
 

NHS service providers:

Zoe REED (South London & Maudsley NHS Foundation Trust)
 

Representing voluntary sector service providers:

Sara MILOCCO (Croydon Voluntary Action)

 

Representing patients, the public and users of health and care services:

Stuart ROUTLEDGE (Croydon Charity Services Delivery Group)

 

Non-voting members:

Ashtaq ARAIN (Faiths together in Croydon)

Jamie KIRBY (London Fire Brigade)

Philip MOCKETT (Metropolitan Police)

Absent:
Lissa ANDERSON (London Probation Trust (Croydon)), Sally CARTWRIGHT (London Fire Brigade), Dr Jane FRYER (NHS England), John GOULSTON (Croydon Health Services NHS Trust), Dr Ellen SCHWARTZ (Acting Joint Director of Public Health), Kim BENNETT (Croydon Voluntary Sector Alliance), Nero UGHWUJABO (Croydon BME), Karen STOTT (Croydon Voluntary Sector Alliance), Adam KERR (National Probation Service (London)), Andrew McCOIG (Croydon Local Pharmaceutical Committee)
Apologies for absence:
Lissa ANDERSON (London Probation Trust (Croydon)), Sally CARTWRIGHT (London Fire Brigade), Dr Jane FRYER (NHS England), John GOULSTON (Croydon Health Services NHS Trust), Kim BENNETT (Croydon Voluntary Sector Alliance), Nero UGHWUJABO (Croydon BME), Karen STOTT (Croydon Voluntary Sector Alliance) Apologies for lateness were also received from Councillor Alisa Flemming.

Item Item/Resolution
MINUTES - PART A
A1/16 MINUTES OF THE MEETING HELD ON WEDNESDAY 9TH DECEMBER 2015

The minutes of the meeting held on 9th December 2015 were agreed as an accurate record, following clarification and revision of item A74/15, as follows:

 

3rd paragraph to read:

"Charlie Ladyman explained every Friday Healthwatch volunteers go over the data in a Patient Experience Panel (PEP). The PEP scrutinises issues, applies clinical coding, identifies serious concerns, monitors equality and diversity, and discovers leading health and social care related trends. "

A2/16 DISCLOSURE OF INTEREST

There were no disclosures of a pecuniary interest not already registered.

A3/16 URGENT BUSINESS (IF ANY)

There was no urgent business.

A4/16 EXEMPT ITEMS

There were no exempt items.

A5/16 APPOINTMENT OF SECOND VICE-CHAIR

THIS ITEM WAS DEFERRED TO THE APRIL MEETING.

A6/16 STRATEGIC ITEMS

Joint Strategic Needs Assessment on Older Adults and Carers of Older Adults

 

Steve Morton and Nerissa Santimano (Public Health Principal) introduced the report. 

 

This JSNA chapter on Older Adults is one of two needs assessments forming part of Croydon's 2014/15 JSNA.  It is based on the framework of goals and desired outcomes established as part of the Outcomes Based Commissioning Programme.  The recommendations put forward in this needs assessment should directly influence future service provision and models of care.

 

The report highlights that older adults and carers of older adults are not just consumers of health and social care services but also important contributors to society and local communities, with a wealth of experience to offer.

 

Members of the Board raised the following issues:

  • Cllr Louisa Woodley mentioned the pressures at work impinging on duties as carers and asked if they are higher amongst ethnic carers and also if there is a higher level of deprivation in BAME communities.
  • Charlie Ladyman suggested that carers wanting to take more care of family members need to be identified and given more support.
  • Cllr Maggie Mansell stressed that more men are now living alone and are more prone to drinking and earlier death.
  • Paul Greenhalgh responded that the Local Strategic Partnership is working on this area.
  • Cllr Maggie Mansell recommended working through the Black Forum and Asian Awareness Centre to raise awareness of services available for carers.

 

The Board AGREED that delegated authority be granted to the Acting Director of Public Health, Executive Director, People Department, Croydon Council and Chief Officer of Croydon CCG to agree any final changes to the document if required.

 

There was a table discussion on the issues raised in this report and the following item, both covering outcomes based commissioning for over 65s (see at the end of the following item).

A7/16 HEALTH AND SOCIAL CARE INTEGRATION: OUTCOMES BASED COMMISSIONING FOR OVER 65S

Paula Swann (Chief Officer, CCG) and Paul Greenhalgh (Executive Director of People, Croydon Council) introduced the report and gave a presentation (see attached).

 

The vision of the Croydon Outcomes Based Commissioning (OBC) Programme is for all partners (statutory, voluntary and community) to come together to provide high quality, safe, seamless care to the older people (age 65 and older) of Croydon that supports them to stay well and independent. Users will have a co-ordinated, personalised experience that meets their needs.

 

(N.B. Councillor Alisa Flemming entered the Chamber at 3pm)

 

There were table discussions following the presentation, each table looking at a different aspect and identifying particular areas or issues that the Board should keep under review in the coming year.

 

Table 1 - "I want to stay healthy and active for as long as possible"

The JSNA makes a number of recommendations on how older people can be supported to stay healthy and active.

 

Key issues raised:

  • Transport - it is not specifically funded.  The Freedom Pass is vital but people need to be able to access public transport.  It is difficult for older and disabled people to get to places where activities are organised for them.  Dial-a-Ride is not always available at the times when they are wanted.  This can lead to isolation.
  • Social prescribing - the importance of keeping people well in their communities, with positive roles.  it is important to keep more people healthy and active by reducing the issues which prevent people from remaining so.
  • GPs need to have the right information to signpost patients.

 

Table 2 - "I want access to the best quality care available in order to live as I choose and as independent a life as possible."

"I want to be supported as an individual, with services specific to me."

The JSNA makes a number of recommendations on how older people can be supported to live as independently as they choose and to be treated as an individual.

 

Key issues raised:

  • Social isolation - it is important to ensure that those living alone have access to the right services.
  • Needs of carers - planning and supporting individuals.
  • Personal care packages - ensuring personal budgets meet the needs of the individual.

 

Table 3 - "I want to be helped by a team/person that has had the training and has the specialist knowledge to understand how my health and social care needs affect me."

"I want good clinical outcomes."

 The JSNA makes a number of recommendations on how professionals and staff can be equipped with knowledge and skills and how good clinical outcomes can be delivered.

 

Key issues raised:

  • Personalisation and variation - not everyone needs the same, so it is important to get the balance right.
  • Clinical outcomes - maintaining the quality of services and patient care by responding to feedback, whilst managing patient expectations.  Frontline staff need to have a wider view.

 

A suggestion was made of a councillor championing older people across departments.  (Councillor Mike Selva has been the Senior Citizens' Champion since May 2014.)

 

The Board NOTED the report.

A8/16 BUSINESS ITEMS

South West London Collaborative Commissioning Update

 

Paula Swann gave a presentation (see attached).

 

In June 2014 the South West London Commissioners published a five year strategy and have been working to deliver it since that point.  As part of the South West London Strategic Planning Group, this five year strategy is being refreshed for the period 2016/17 to 2021/22.  Health and Wellbeing Boards and Local Authorities will be closely involved in the development and delivery of this strategy.

 

The following comments were made:

  • People are being pushed to have more collaboration with SW London but we want to operate as Croydon. 
  • How can we ensure we continue to meet the needs of Croydon within a bigger footprint?  For some things it is sensible to do them locally but for others it makes sense to do them over a bigger footprint. 
  • The same outcomes and standards of care need to be agreed across SW London. 
  • Implementation is a local issue, so SW London Strategic Groups at sub levels are being set up, in order to keep local focus, and Croydon is one.
  • Mental health services for Croydon are provided by SLaM but other CCGs across SW London are covered by St George's Mental Health Trust.
  • Whether there are more young people or more older people, we still have to deliver the right services to the same standard.

 

Some questions were also raised:

  • National Government has put a ban on sending people to mental health beds miles away from their homes - how is Croydon coping?

Response: Numbers in Croydon had reduced but are creeping up again.  It is a difficult issue, as we do not always have the right services available locally.  There are not enough staff in mental health services and we need to look at how services are delivered.

There is a need to resource the community side, to help deal with the problem locally.

  • What support is there for housing, transport and other issues?

Response:  There is a significant amount of investment now to improve these issues.

 

This report was for information only.

 

A proposal to have a seminar on this issue will be taken to the Executive Group.

A9/16 JSNA WORK PROGRAMME 2016

Steve Morton gave a summary of the report.

 

The paper set out revised proposals for the 2016 JSNA programme and governance of the JSNA process.  Two focused JSNA needs assessments are to be taken forward in sequence in 2016:

  • Social isolation
  • Patient activation and health literacy

 

In addition, it was proposed to take forward a needs assessment on adults with learning disabilities, outside the JSNA process.

A simplification of JSNA governance arrangements was also proposed.

 

The Board AGREED the proposals.

A10/16 REPORT OF THE CHAIR OF THE EXECUTIVE GROUP

Paul Greenhalgh summarised the report.

 

At a seminar which took place in August 2013, Board members identified a number of strategic risks which have been kept under review.

The Work Plan for 2015/16 was agreed at the Board meeting on 25 March 2015.  This is regularly reviewed by the Executive Group and the Chair.

 

The Board RESOLVED to

  1. Note risks identified at appendix 1
  2. Agree proposed changes to the board work plan set out at paragraph 3.4
     
A11/16 PUBLIC QUESTIONS

There were no public questions.

MINUTES - PART B
  None
The meeting ended at 3:55pm